This article is more than 5 years old. Information may no longer be current.
CKD, new-onset AF may predict post-TAVR cerebrovascular events
Click Here to Manage Email Alerts
A new study has identified four predictors of early cerebrovascular events following transcatheter aortic valve replacement: chronic kidney disease, new-onset atrial fibrillation, female sex and study enrollment date.
Vincent Auffret, MD, MSc, from Quebec Heart and Lung Institute, Laval University, Quebec City, Canada, and Rennes 1 University, Signal and Image Processing Laboratory, France, and colleagues sought to evaluate predictors of 30-day cerebrovascular events after TAVR. The researchers analyzed data from 64 studies involving 72,318 patients. From that cohort, 2,385 patients who underwent TAVR experienced a cerebrovascular event within 30 days.
The incidence of cerebrovascular events ranged from 1% to 11% (median, 4%). The researchers reported no significant differences in the incidence of cerebrovascular events between single and multicenter studies or according to availability of cerebrovascular event adjudication.
Summary risk ratios (RR) revealed a lower risk for cerebrovascular events among men (RR = 0.82; P = .02), but a higher risk for patients with chronic kidney disease (RR = 1.29; P = .03), new-onset AF (RR = 1.85; P = .005) and TAVR performed during the first half of center experience (RR = 1.55; P = .003), according to the results. The researchers also determined that the use of balloon post-dilation was linked with increased risk for cerebrovascular events (RR = 1.43; P = .07).
Use of a balloon-expandable vs. self-expandable valve or use of transfemoral vs. non-transfemoral access were not predictors of cerebrovascular events.
“This represents a first step to help us implement further preventive measures (eg, use of embolic protection devices, optimizing antithrombotic therapy post-TAVR) in those patients at highest risk. Because TAVR is set to expand its indication to lower surgical-risk patients, cerebrovascular events remain an ongoing problem, and future efforts should aim at identifying patients who would benefit from tailored therapies,” Auffret and colleagues wrote. – by James Clark
Disclosure: Auffret reports receiving grants from Abbott Vascular, Biosensors, Boston Scientific, Edwards Lifesciences, Medtronic and Terumo. Please see the full study for a list of the other researchers’ relevant financial disclosures.
Click Here to Manage Email Alerts